Bedwetting can affect both children and adults. Potential causes of bedwetting may include hormonal imbalances, stress, smaller bladder capacity, and sleep problems.
Young children will often grow out of bedwetting naturally. In older children, teenagers, and adults can indicate an underlying health condition.
This article will look at possible causes of bedwetting in children and adults, some treatment options, and when to see a doctor.
Bedwetting is an involuntary release of urine when sleeping. It will usually happen at night, but it may also happen if a person naps or sleeps during the day. Other names for bedwetting include nighttime incontinence and nocturnal enuresis.
Bedwetting can cause:
- a rash or irritation around the genital area
- withdrawal from social activities
- feelings of embarrassment or frustration
- self-esteem or confidence issues
Some causes of bedwetting that affect both adults and children include:
- Hormonal imbalance: The body produces antidiuretic hormone (ADH) to slow urine production at night. If the body is not producing enough ADH, or if the kidneys are not responding to the hormone as usual, it can cause bedwetting.
- Genetics: People are more likely to wet the bed if they have a family history of bedwetting.
- Bladder capacity: If a person has a smaller bladder capacity, they may be unable to hold urine throughout the night.
- Urinary tract infection (UTI): A UTI can cause issues with urinating and bedwetting.
- Stress and anxiety: Stressful events, life changes, and trauma can all cause bedwetting.
- Sleep disorders: Obstructive sleep apnea and sleepwalking can cause the body to produce atrial natriuretic peptide. This is a substance that increases diuresis, or excretion of urine, which leads to more urine production.
Some of the following causes of bedwetting are specific to children:
- An undeveloped connection between the brain and bladder: The brain and bladder communicate to control urination. In some children, this connection may be slow to develop. During deep sleep, a child may not recognize the need to wake up to empty their bladder.
- Type 1 diabetes: Bedwetting can be an initial symptom of type 1 diabetes in children.
- Chronic constipation: If stools remain in the bowel, it can put excess pressure on the bladder, possibly leading to a lack of control over urination.
- Problems with the urinary tract or nervous system: If the structure of the urinary tract or nervous system has not developed properly, it may cause bedwetting.
- Attention deficit hyperactivity disorder (ADHD): Children with ADHD are more likely to wet the bed.
- Caffeine and carbonated beverages: Both caffeinated and carbonated beverages can cause the kidneys to increase urine production in children.
A variety of factors can cause bedwetting in adults. These include:
- Overactive bladder muscles: Overactive bladder muscles can cause nighttime urination. Around 70–80% of adults who wet the bed have overactive bladder muscles.
- Alcohol and caffeine: Both alcohol and caffeine can affect the bladder muscles and increase the rate at which the body produces urine, which may increase the risk of bedwetting.
- Stress: Severe stress and anxiety can both cause bedwetting.
Side effects of certain medications may cause bedwetting. Medications that may increase the risk of bedwetting include:
- medications for insomnia
- psychiatric medications, such as risperidone, thioridazine, and clozapine
- medications to treat anxiety
- medications for cardiovascular and blood pressure conditions
If none of the above are causing bedwetting in adults, the behavior could indicate an underlying medical condition.
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The sections below will look at treatment options and prevention methods for bedwetting in both children and adults.
Treatment for bedwetting in children will depend on the underlying cause. People may want to try a bedwetting alarm, which sounds when the alarm detects wetness.
Taking steps to help prevent bedwetting can also be effective. Options to try include:
- limiting fluid intake in the evening or 1–2 hours before bedtime
- avoiding caffeine and carbonated drinks, as these can stimulate the bladder
- encouraging children to use the bathroom at night and making it easy for them to access, using night lights if this helps
- encouraging children to use the bathroom at the beginning of their bedtime routine and just before they get into bed to empty the bladder
- encouraging children to use the bathroom regularly throughout the daytime to develop positive toilet habits
The following measures may also help:
- helping or encouraging children to wash their genital area after bedwetting to reduce the chance of irritation or rashes
- changing any wet clothing and bedding straight away
- using a plastic mattress cover
- talking to children about bedwetting and letting them know that it is not their fault and nothing to feel embarrassed or anxious about
- not talking about bedwetting in front of people outside of healthcare professionals, as this may make children feel more anxious or embarrassed
- discouraging any teasing from siblings or family members
People may find that a combination of techniques is the most effective way of treating and preventing bedwetting in children.
Bedwetting in adults may be a symptom of an underlying condition that will require treatment. Successfully treating or managing that condition should resolve bedwetting behavior.
Certain steps can also help manage bedwetting, including:
- taking a medication called desmopressin, which acts on the kidney to reduce urine production
- using a plastic cover to protect the mattress and make cleaning up quicker and easier
- wearing absorbent underwear at night
- using skincare products that protect the skin from any irritation or soreness
- limiting fluid intake in the early evening and before sleeping
- using a bedwetting alarm, which sounds when the alarm detects wetness
- setting a random alarm to go off in the night so that a person can wake up and go to the bathroom
In some cases, medication may help reduce bedwetting, but this will not provide a complete cure. People can discuss possible side effects with a doctor.
If there is an anatomical problem with the bladder or urinary tract, a person may require surgery.
Bedwetting is normal for young children, who will usually grow out of it. Home treatments and training may be enough to prevent bedwetting.
People can talk to their doctor if they have any concerns about the well-being of a child, or if the child:
- is older than 7 years
- did not wet the bed for 6 months but then started to again
- has additional symptoms that could indicate a UTI or underlying condition
- is wetting themselves in the daytime
- is emotionally affected by bedwetting
Adults should see a doctor about bedwetting, as this can indicate an underlying health condition.
The doctor will take a full medical history, assess the symptoms, and carry out a physical exam. They may also carry out urine tests and take X-rays to look at the health of the urinary tract and kidneys.
Bedwetting is normal for young children, and they will usually grow out of it naturally.
Older children who are still bedwetting may require extra support to stop bedwetting. In some cases, an underlying health condition may be causing bedwetting in older children.
Medications and underlying health conditions can cause bedwetting in adults, and a person should see their doctor to determine the cause and receive appropriate treatment.